Fistula And Hernia Management: Case Study Using Adapt Barrier Rings.pdf

Mrs. R, a 71-year-old with a history of multiple abdominal surgeries including three caesarean sections and an above-the-knee amputation, developed complications leading to a year-old ileostomy. She experienced repeated issues with fistulae, abscesses, and wound breakdown due to constant contamination from small bowel content.

Initial Management:
- Initial management involved using a large wound manager over Hollister Adapt Barrier Rings to pouch both the wound and stoma.
- The wound became sloughy and constantly contaminated, but the ileostomy continued to function.

Challenges:
- Silastic foam dressings inserted into the laparotomy wound to plug the gap between the wound and stoma leaked due to high output.
- A convex pouch was attempted but unsuccessful due to a large skin fold under the stoma.

Solution: Adapt Barrier Rings
- Hollister Adapt Barrier Rings were introduced for extended wear time, flexibility, and secure attachment despite skin creases.
- The rings filled dips and creases around the stoma, creating a flat surface area for flange attachment.
- Adapt Paste was used to maintain a seal and fill further skin creases.

Outcome:
- Accelerated healing and successful management at home with district nurse support.
- Patient's positive attitude and willingness to try new treatments facilitated recovery.
- Adapt Barrier Rings provided comfort, flexibility, and longer wear time, addressing previous challenges.